Abstract An estimated 5.5 million Americans age 65 and older are living with Alzheimer's disease (AD) and as the population ages, this number is expected to rise to 13.8 million by 2050. Agitation is one of the most common and distressing neuropsychiatric symptoms of Alzheimer's disease and related dementias (ADRD) for patients in the ambulatory and long-term care (LTC) settings. Agitation contributes to increased healthcare costs, greater caregiver distress and worse quality of life. A significant challenge in the management of agitation is obtaining real-time objective data on symptom patterns. Symptom rating scales are time consuming and frequently underutilized by LTC staff. Such subjective differences in symptom reporting makes measurement of treatment response or non-response quite difficult. Clinicians, LTC staff and caregivers need a more cost effective, simple way to objectively measure agitation. While efforts have been made to capture this data using wireless sensors, none to date have been made commercially available. CareBand, an Illinois-based small business, is developing an end-to-end wearable technology and real-time data platform for people living with ADRD. Preliminary studies have demonstrated CareBand's ability to provides real-time indoor and outdoor precise location, movement, and activity data. CareBand's system is passive, always on and does not require wi-fi or traditional cellular technology to send data to the secure HIPAA-compliant CareBand cloud. In Phase I, the PI and collaborating site, Bethany Village, will determine the feasibility and user acceptability of the device as well as the ability to correlate agitation scale data to that of CareBand's data. Aims: 1: Engineer power- efficient firmware to collect granular motion data within a given room or hallway (e.g. pacing) and to build cloud logic to analyze this granular data for web and mobile applications. 2: Test CareBand in the Bethany Village long-term care facility with 15 dementia patients and 15 staff members for a period of 6 weeks. 3: Evaluate the outcomes of CareBand for usability among patients, families, and staff and its ability accurately detect agitation. At the end of Phase I, CareBand will have implemented the CareBand technology in a long term care facility environment, received feedback on the hardware and software from end users, and assessed correlation of agitation with increased patient movement . Phase II efforts will focus on construction of algorithms informed by any findings of correlation, the creation of a predictive model around impending agitation, and a longitudinal study in multiple long-term care facilities serving individuals with ADRD. Phase II may also include adding heartrate sensors to the CareBand device for enhanced agitation measurements. A significant market opportunity exists for the CareBand technology in alerting caregivers to early signs of agitated behavior in people living with dementia, allowing caregivers to intervene before the need for psychotropic medication or hospitalization. This preemptive intervention enhances quality of life for individuals living ADRD and it decreases burden on caregivers.